This is very timely for me. I went to see my doctor yesterday for routine blood work to monitor my thyroid. She wanted to schedule me for a carotid artery ultrasound, to screen for stroke or heart attack. This was news to me. I asked why, knowing I have NO risk factors...well, mildly elevated cholesterol, but nothing else. But I do have good health insurance, which would cover the cost of the test. Oh, the tests she's tried to order for me, and lousy patient that I am, I turn them all down, because although I'm getting older, I'm in excellent health. Yep, progress for sure.

My kid had a bad cough with some chest congestion. I took her to the doc when it lasted more than a week--reluctantly at that because she was otherwise bright-n-shiny healthy). He gave her some cough syrup and said, "not much we can do and wait it out ..." which was pretty much what I figured.

He said to bring her back in 3 weeks for a follow up. I did, against my better judgement, becuase by then, she was 100 percent.

He takes one look at her, asks, "Why are we seeing Jessica today?"

"For a follow up on her cough," I said.

"Oh," he said. Then he tells me to take her to an allergist for two appointments to figure out why she was coughing before.

I left the office, through out the recommendation note and never saw that doctor again.

One of the pieces of the pie here that no one is talking about is The Great American Hypochondriac. How many moms would have taken that cluck's advice and gone to an expensive allergist just because their insurance was picking up the bill?

And you KNOW that damn allergist would have come up with some goddamn pill to give the kid.

There's lot's of disease in the HC system that has nothing to do with illness. I do believe that guy was the exception, but you have to have some street smarts. You have to second guess the doc when he/she seems full of shit.

In 1990, the average cost for a pregnancy and childbirth was $5,000 +/-. I had some complications and needed a C-section, so add some more - let's say it should have been $8,000. Amber's arrival ticket was punched for more than $20,000! Oh, did I fail to say that BOTH Ex and I had big, fat, juicy Blue Cross of California policies?

Dang! I had one of my great super long rambly comments ready to post, and I accidentally closed out of it before I hit "post." Argggh!

But the gist of it was: For all the co-pays and premiums I've paid in the last couple of years, I should have a freakin wing of the hospital named after me. Better yet, I should have my own rooftop condo at the hospital with cute doctors and hot nurses to wait on me night and day. Oh, and I want a helipad too!

But no. I co-pay and pay and pay, and they co...nothing.

Whatever the healthcare reform turns out to be, sign me up! It's got to be better than what I have now....or surely it can't be any worse.

Oh...I almost forgot about this. When I was 12, I had one of my first knee surgeries. I was in hospital for 5 days...checked in the night before and had a private room with a view. It was practically like a vacation! (I had a similar surgery a couple of years ago, but with the new technologies, I was in and out in a day!)

Back when I had that first surgery, it cost only $1200 for the whole deal...out of pocket, no insurance.

Amazingly, my parents had made a trip to Reno, Nevada a couple of weeks before my surgery and won exactly $1200 on the first quarter they put in at the slot machines. I kid you not!

The last surgery I had, in and out in one day, cost around $12,000. Eeeek!

I was in Chicago for a conference last week; last night I was there I somehow busted open a set of sutures (bacterial cyst; removed by a specialist on appointment - no out-of-pocket pay on my behalf) just under my eyebrow overnight.

Lots of blood, I freaked out, thought about getting it checked out in an ER in Chicago... thought better of it. The sutures had completely split, healing was far far less than I had expected, and I basically had two flaps of skin tearing away from each other and a droopy eyelid. Talking to the specialists afterwards, if I hadn't had it put back together by someone who knew both their ways around plastics and eyes, I would have ended up with a large scar and perhaps wonky eye; if I didn't get it looked at, I'd end up with a massive scar and a wonky eye.

Neither of which are life threatening, and when I got checked out at ER, there was no bleeding and I was walking around just fine with no acute problems.

I made it back to Vancouver around 5.30p, took transit from the airport back to my apartment to drop off bags, bussed out to the ER, ~2 hours later I was told to head out to the Eyecare Center 5 minutes away and wait for a phone call. Get there, wait for a few, phone call, 2 specialists showed up at 10pm on a Thursday night, let me into their office, chatted amiably while the local kicked in, and put me back together like plastic surgeon superstars.

Cost to me - nothing out of pocket.

--

After the procedure, I talked with them a little bit about this experience - it seems like their experience is that in the Canadian system, although they might not get paid as much, they get paid 90+ percent of the time (the subtext is that that may not be the case in the US) and they don't have to pay out nearly as much in malpractice insurance and they don't have to worry about compromising what services to offer based on what their patients are able to pay (and beyond the ethical/moral calculus, also the practical side of figuring it out). In addition to a bunch of other 'living in Canada/Vancouver' things.

See. Even in 1961 people were running to the emergency room to get a mior injury taken care of. I bet he sat in the waiting room for a couple of hours. Everyone knows that you just slab some butter on the burn and wrap it in a rag. Besides, back then a gallon of gas, for example was about 15 cents so #3.25 for some salve and gauze wasn't such a good deal. I'm still in a bad mood.